Atorvastatin as a first choice drug in patients with impaired renal function Review article
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Published:
Dec 31, 2015
Keywords:
chronic kidney disease, statins, cardiovascular disease, atorvastatin
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Abstract
Cardiovascular diseases are a serious medical issue in patients with chronic kidney disease (CKD), and their incidence is particularly high in end-stage renal failure. According to the latest guidelines, the vast majority of patients with progressive CKD is eligible for statin therapy, which in light of the available research reduces the risk of cardiovascular events in this group of patients. Statins are recommended for use regardless of the CKD stage, including patients treated with renal replacement therapy. Atorvastatin should be treated as a drug of first choice due to its proven nephroprotective effect. Unfortunately, many clinicians still believe that high-dose statin therapy in advanced CKD should be prescribed with caution. Changing this belief will probably be possible only after prospective randomized studies on a large group of patients are carried out.
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Pawlaczyk, K., Schwermer, K., Hoppe, K., & Bręborowicz, P. (2015). Atorvastatin as a first choice drug in patients with impaired renal function. Medycyna Faktow (J EBM), 8(4(29), 50-53. Retrieved from https://www.journalsmededu.pl/index.php/jebm/article/view/2282
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References
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12. Ray K.K., Cannon C.P., McCabe C.H. et al.; PROVE IT-TIMI 22 Investigators: Early and late benefits of high-dose atorvastatin in patients with acute coronary syndromes: results from the PROVE IT-TIMI 22 trial. J. Am. Coll. Cardiol. 2005; 46(8): 1405-1410.
13. Wong M.G., Wanner C., Knight J., Perkovic V.: Lowering cholesterol in chronic kidney disease: is it safe and effective? Eur. Heart J. 2015: ehv393.
14. Ridker P.M., Danielson E., Fonseca F.A. et al.; JUPITER Study Group: Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N. Engl. J. Med. 2008; 359(21): 2195-2207.
15. Zewinger S., Speer T., Kleber M.E. et al.: HDL cholesterol is not associated with lower mortality in patients with kidney dysfunction. J. Am. Soc. Nephrol. 2014; 25(5): 1073-1082.
2. Cholesterol Treatment Trialists’ (CTT) Collaboration; Baigent C., Blackwell L., Emberson J. et al.: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 2010; 376(9753): 1670-1681.
3. Sever P.S., Dahlöf B., Poulter N.R. et al.; ASCOT Investigators: Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial – Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet 2003; 361(9364): 1149-1158.
4. Colantonio L.D., Baber U., Banach M. et al.: Contrasting Cholesterol Management Guidelines for Adults with CKD. J. Am. Soc. Nephrol. 2015; 26(5): 1173-1180.
5. Wanner C., Tonelli M.; Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group: KDIGO Clinical Practice Guideline for Lipid Management in CKD: summary of recommendation statements and clinical approach to the patient. Kidney Int. 2014; 85(6): 1303-1309.
6. Tonelli M., Wanner C.; Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group Members: Lipid management in chronic kidney disease: synopsis of the Kidney Disease: Improving Global Outcomes 2013 clinical practice guideline. Ann. Intern. Med. 2014; 160(3): 182.
7. de Zeeuw D., Anzalone D.A., Cain V.A. et al.: Renal effects of atorvastatin and rosuvastatin in patients with diabetes who have progressive renal disease (PLANET I): a randomised clinical trial. Lancet Diabetes Endocrinol. 2015; 3(3): 181-190.
8. Jacobson T.A.: Statin safety: lessons from new drug applications for marketed statins. Am. J. Cardiol. 2006; 97(8A): 44C-51C.
9. Sidaway J.E., Davidson R.G., McTaggart F. et al.: Inhibitors of 3-hydroxy-3-methylglutaryl-CoA reductase reduce receptor-mediated endocytosis in opossum kidney cells. J. Am. Soc. Nephrol. 2004; 15(9): 2258-2265.
10. Moorhead J.F., Chan M.K., El-Nahas M., Varghese Z.: Lipid nephrotoxicity in chronic progressive glomerular and tubulo-interstitial disease. Lancet 1982; 2(8311): 1309-1311.
11. Hou W., Lv J., Perkovic V. et al.: Effect of statin therapy on cardiovascular and renal outcomes in patients with chronic kidney disease: a systematic review and meta-analysis. Eur. Heart J. 2013; 34(24): 1807-1817.
12. Ray K.K., Cannon C.P., McCabe C.H. et al.; PROVE IT-TIMI 22 Investigators: Early and late benefits of high-dose atorvastatin in patients with acute coronary syndromes: results from the PROVE IT-TIMI 22 trial. J. Am. Coll. Cardiol. 2005; 46(8): 1405-1410.
13. Wong M.G., Wanner C., Knight J., Perkovic V.: Lowering cholesterol in chronic kidney disease: is it safe and effective? Eur. Heart J. 2015: ehv393.
14. Ridker P.M., Danielson E., Fonseca F.A. et al.; JUPITER Study Group: Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N. Engl. J. Med. 2008; 359(21): 2195-2207.
15. Zewinger S., Speer T., Kleber M.E. et al.: HDL cholesterol is not associated with lower mortality in patients with kidney dysfunction. J. Am. Soc. Nephrol. 2014; 25(5): 1073-1082.